In August 2013 the Ontario Government changed the way publicly funded physiotherapy is delivered in the community. Approved private clinics and Family Practice Health Teams are now able to offer OHIP funded physiotherapy. These clinics are granted a number of treatment blocks per injury/condition in a year, subject to a maximum of $312.00. Let’s say you fractured a shoulder the clinic would only be able to cover you up to this amount. It doesn’t take complicated math to work out that the clinic isn’t going to be able to treat this injury effectively, with the time per session that it needs, or for the total duration it can take. At $312 per condition, it is virtually impossible to treat someone effectively and with the quality of care to achieve their pre-injury level of function.

Some hospitals still provide physiotherapy services to the community, however this is very limited and most hospitals have reduced this service because they are not mandated to fund it. For instance, if you endure a hand injury, you should be requesting treatment at a hospital out-patient hand clinic. The hospitals have had to continue to provide these clinics because the private sector cannot provide this specialty. However, if you have a serious hand injury, you may need a splint for a while, hence a referral to the hand clinic is essential.

I am not sure how these clinics are managing these patients with this level of financial constraint. One of the criticisms of OHIP physiotherapy clinics is that the perceived treatment is sub-standard. Patients are basically hooked up to machines and then told to go into a gym with support personnel. The level of one-on-one care is minimal as the private clinic has to process several of these OHIP patients to make a profit. Remember these are private clinics only receiving funding for OHIP patients, not public clinics.

There are some home-care and hospital out-patient physiotherapy services for patients having hip or knee replacement surgeries. The advice from the government is that these patients should not need further treatment in community OHIP clinics. I know from experience this is not realistic in most cases. I recently had a patient who had hip surgery and was given just four out-patient sessions at the hospital over a four week period. Definitely not enough to allow her to gain full strength and range of motion.

The following are the eligibility criteria for OHIP funded physiotherapy in the community. The eligibility requirements for patients remain the same as under the previous OHIP system. To be eligible for publicly-funded physiotherapy in a participating clinic, patients must have a valid Ontario heath card, a referral from their physician or nurse practitioner, and be:

  • age 65 or older;
  • age 19 or younger;
  • any age after overnight hospitalization for a condition that requires physiotherapy (and for which they are not otherwise eligible through other publicly funded programs)
  • a recipient of Ontario Works or the Ontario Disability Support Program (with or without a valid Ontario health card).

For additional information on this topic I would suggest you ask your doctor if they have a physiotherapist on staff. If you have any specific questions about OHIP funded physiotherapy, I am happy to answer them and point you in the right direction of further resources.

 

About the Author

Damian Wyard trained is a Registered Physiotherapist and Stott Pilates Rehabilitation Instructor with 20 years experience in his field. He is the owner of Pilates4Physio in Toronto. You can reach him privately at info@pilates4physio.ca, or at his Pilates studio www.pilates4physio.ca www.facebook.com/pilates4physio